The global insurance fraud investigation outsourcing market was valued at USD 525 Million in 2019 and is projected to reach USD 2,154 Million by 2027, expanding at a CAGR of 19.6% during the forecast period. The market is driven by factors such as greater expertise, reduction in risk and cost for insurance companies, increasing adoption of advanced analytics techniques, and stringent regulatory compliances. Conversely, difficulties in detection and prosecution of insurance fraud and enormous costs involved in fighting fraud are likely to restrain the market. significance of social media and increasing adoption of technology are creating opportunities in the market.
The outsourcing companies have collective experience and expertise of an outsourcer's investigative workforce. These experts are aware about the insurance industry, claiming process, several fraud schemes, and technology and processes required to investigate, prevent, and detect fraud. Additionally, they are aware about the prosecutorial process and requirement for a successful prosecution. One of the key advantages offered by the fraud investigation outsourcing expertise is the best practice implementation for the overall investigation process. Outsourcing experts implement and recommend procedures covering all phases of fraud investigation from resolution to claim referral, which lead to more impressive outcomes than with a less practiced in-house Special Investigative Unit (SIU).
Training is a major expenditure for insurers to handle insurance fraud investigation in house. Insurance fraud investigation outsourcing reduces expenses for an insurance company and eases an insurer's possibility for bad-faith lawsuits. If an in-house investigator goes out of line to investigate a claim, the insurer is responsible for the legal penalties. However, if a service provider steps out of line to investigate a claim, the insurer points to its contract and make the case that the vendor broke the contractual duty, potentially defending itself from a bad-faith claim.
Advanced analytics techniques are a set of analytical techniques that analyze enterprises’ database and systems to identify the vulnerabilities of frauds. Advanced analytics play an important role in incorporating internal data with third-party data to increase fraud detection abilities. These solutions analyze and monitor data from various data sources, offer a control mechanism to avoid fraudulent practices in real-time, and detect suspicious & unusual and anomalies behavior across all channels. The adoption of analytics has reinforced fraud detection.
Insurers work to increase profits and cut costs by offering targeted insurance resolutions to their customers, insurers constantly modernize their compliance and regulatory functions to meet their ethical and legal ethical obligations cost-effectively and sustainably. The insurance fraud investigation market is expected to grow during the forecast period owing to restricted entry of new market players due to stringent regulatory compliances, which decreases the competition in the market.
By Types Segment
In terms of types, the insurance fraud investigation market is segmented into healthcare fraud investigation, auto insurance fraud investigation, property insurance fraud investigation, workers compensation fraud investigation, and others. The healthcare segment is future divided into policyholder fraud/claims fraud, intermediatory fraud, and internal fraud. The auto insurance fraud investigation segment held 31.3% share of the market in 2020 owing to the increasing filing of fake damages. The healthcare fraud investigation segment is anticipated to expand at a CAGR of 19.8% during the forecast period.
By Applications Segment
On the basis applications, the market is segmented into large insurance companies, medium and small insurance companies, and third-party administrators (TPA’s). The large insurance companies segment accounted for a market share of 50.8% in 2020, while the medium and small insurance companies segment is anticipated to expand at a CAGR of 19.9% during the forecast period.
Region Wise Outlook
On the basis of regions, the market is categorized as North America, Europe, Asia Pacific, Latin America, and Middle East & Africa (MEA). North America is a promising region of the market. The region constituted 38% share of the market in 2020. The demand for insurance fraud investigation outsourcing is expected to rise due to increasing adoption of advanced analytics techniques. The market in Asia Pacific is projected to expand at a CAGR of 20% during the forecast period due to increasing awareness regarding rising instance identity thefts, payment frauds, and claims fraud in the region.
Key Benefits for Industry Participants & Stakeholders
- In-depth Analysis of the Insurance Fraud Investigation Outsourcing Market.
- Historical, Current and Projected Market Size in terms of Value.
- Potential & Niche Segments and Regions Exhibiting Promising Growth Covered
- Industry Drivers, Restraints and Opportunities Covered in the Study
- Recent Industry Trends and Developments
- Competitive Landscape & Strategies of Key Players
- Neutral Perspective on from insurance fraud investigation outsourcing market Performance
- Healthcare Fraud Investigation
- Policyholder Fraud/Claims Fraud
- Intermediatory Fraud
- Internal Fraud
- Auto Insurance Fraud Investigation
- Property Insurance Fraud Investigation
- Workers Compensation Fraud Investigation
- Large Insurance Companies
- Medium and Small Insurance Companies
- Third-party Administrators (TPA’s)
- North America
- Asia Pacific
- Latin America
- Middle East & Africa (MEA)
Key Market Players Profiled in the Report
- Verity Consulting Limited.
- PJS Investigations
- Corporate Investigative Services
- ICORP Investigations
- Brumell Group / Brumell Investigations Inc.
- John Cutter Investigations (JCI)
- Kelmar Global
- RGI Solutions
- Delta Investigative Services
- Integrated Security Services
- SECURaGLOBE Solutions, Inc.
- Key players in the insurance fraud investigation outsourcing market Brumell Group / Brumell Investigations Inc., Corporate Investigative Services, CoventBridge, crigroup.com., Delta Investigative Services, ICORP Investigations, Integrated Security Services, John Cutter Investigations (JCI), Kelmar Global, PJS Investigations, RGI Solutions, RobertsonandCo, Suzzess, SECURaGLOBE Solutions, Inc., and Verity Consulting Limited. These companies are considered as key market players of insurance fraud investigation outsourcing market, based on their revenue, research & development (R&D) activities in the areas of improving service offerings, and regional presence.
- The players are adopting key strategies such as product development, geographical expansion, mergers and acquisition and many other strategies to increase their demand for insurance fraud investigation.